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Brain tissue oxygen pressure and cerebral metabolism in an animal model of cardiac arrest and cardiopulmonary resuscitation.
- Source :
-
Resuscitation [Resuscitation] 2006 Oct; Vol. 71 (1), pp. 97-106. Date of Electronic Publication: 2006 Aug 30. - Publication Year :
- 2006
-
Abstract
- Objective: Direct measurement of brain tissue oxygenation (PbtO2) is established during spontaneous circulation, but values of PbtO2 during and after cardiopulmonary resuscitation (CPR) are unknown. The purpose of this study was to investigate: (1) the time-course of PbtO2 in an established model of CPR, and (2) the changes of cerebral venous lactate and S-100B.<br />Methods: In 12 pigs (12-16 weeks, 35-45 kg), ventricular fibrillation (VF) was induced electrically during general anaesthesia. After 4 min of untreated VF, all animals were subjected to CPR (chest compression rate 100/min, FiO2 1.0) with vasopressor therapy after 7, 12, and 17 min (vasopressin 0.4, 0.4, and 0.8 U/kg, respectively). Defibrillation was performed after 22 min of cardiac arrest. After return of spontaneous circulation (ROSC), the pigs were observed for 1h.<br />Results: After initiation of VF, PbtO2 decreased compared to baseline (mean +/- SEM; 22 +/- 6 versus 2 +/- 1 mmHg after 4 min of VF; P < 0.05). During CPR, PbtO2 increased, and reached maximum values 8 min after start of CPR (25 +/- 7 mmHg; P < 0.05 versus no-flow). No further changes were seen until ROSC. Lactate, and S-100B increased during CPR compared to baseline (16 +/- 2 versus 85 +/- 8 mg/dl, and 0.46 +/- 0.05 versus 2.12 +/- 0.40 microg/l after 13 min of CPR, respectively; P < 0.001); lactate remained elevated, while S-100B returned to baseline after ROSC.<br />Conclusions: Though PbtO2 returned to pre-arrest values during CPR, PbtO2 and cerebral lactate were lower than during post-arrest reperfusion with 100% oxygen, which reflected the cerebral low-flow state during CPR. The transient increase of S-100B may indicate a disturbance of the blood-brain-barrier.
- Subjects :
- Animals
Cerebrovascular Circulation
Disease Models, Animal
Electric Countershock
Female
Heart Arrest physiopathology
Lactates metabolism
Male
Swine
Vasopressins administration & dosage
Ventricular Fibrillation metabolism
Brain metabolism
Brain Chemistry
Cardiopulmonary Resuscitation
Heart Arrest metabolism
Oxygen analysis
Subjects
Details
- Language :
- English
- ISSN :
- 0300-9572
- Volume :
- 71
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Resuscitation
- Publication Type :
- Academic Journal
- Accession number :
- 16942830
- Full Text :
- https://doi.org/10.1016/j.resuscitation.2006.03.007